Breast Cancer Husband

The impact of breast cancer is a tremor felt by every member of the family. Marc Silver felt this emotional earthquake when his wife was diagnosed. His experience led to a book, Breast Cancer Husband, which addresses men's common questions and concerns when faced with a partner's breast cancer diagnosis. He joined us to talk about it on Oct. 20, 2004.

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reviewed by a WebMD physician. If you have questions about your health, you
should consult your personal physician. This event is meant for informational
purposes only.

MODERATOR: Welcome to WebMD Live, Marc. Thank you for joining us today. Please tell us about your experience that led to Breast Cancer Husband .

SILVER: My wife was diagnosed with breast cancer three years ago and boy, was I clueless. I instinctively did all the wrong things. I tried to fix the cancer, I tried to cheer my wife up instead of really trying to listen to her, and I thought it was my job to run the medical show. The one thing I wished for was a book that would have helped me cope, and when my wife finished her treatments I began writing Breast Cancer Husband .

MEMBER QUESTION: What was your first reaction when you were told that your wife had breast cancer?

SILVER: My wife had gone to the radiologist for a mammogram call back, and neither of us was very worried because she'd had plenty of callbacks before and there was never any bad news. But this Friday morning she called me at work at around 11 o'clock with the news the radiologist had looked at the mammogram and said, "Sure looks like cancer to me." Marsha loves to remind me of my response: "Oh, that doesn't sound good." Instead of running home to be with her I said, "Well, see you tonight, honey."

MODERATOR: Oops! So how did you proceed to patch that up!

SILVER: I think I began making amends the next Tuesday when Marsha could visit a surgeon. And I went along with her because that was the one correct instinct I had. I saw that I could be a tremendous help to her in the doctor's office. I took notes, because that's what I do as a living as a reporter. I later learned that patients often forget things said to them in such stressful situations, so the notes were a big help. I'd also keep track of the questions she wanted to ask and gently remind her if she had forgotten one.

I began to understand this was Marsha's disease to deal with and my job was to support her as she gathered information and faced many difficult decisions about treatment.

MEMBER QUESTION: Did you go with your wife to her doctor's appointments? Did she want you there with her?

SILVER: Marsha absolutely wanted me there with her. I've learned some women will say to their husband, "That's OK, you don't have to take off from work, I can handle it." It think what the husband should say is, "Honey, I love you and I want to be by your side when you're at the doctor's office."

There are some cases when the woman really doesn't want her husband there, like the patient who told me her husband cried at the doctor's office. Or she may prefer the company of a sister or friend. So, there are some exceptions to the rule, but in general my sense is the husband should be by his wife's side.

"I tried to cheer my wife up instead of really trying to listen to her, and I thought it was my job to run the medical show."

MEMBER QUESTION: You said you tried to cheer her up. Was depression a problem for her? For you?

SILVER: At times Marsha was very depressed, and understandably so. What I had to learn was to let her feel what she was feeling and not try to cheer her up. I think if feelings of depression had lingered for a long spell we might have sought professional help, but in our case, Marsha usually was able to rally after hearing bad news. I was more scared than depressed. And I didn't share those feelings with my wife.

Many therapists have told me how important it is for husbands to disclose their deepest feelings. And I've talked to couples that did share and found that sharing brought them closer together. But I've also asked women if they would have wanted to know how frightened their husband was at this time, and their response often was, "Hell, no." So in some situations it may be a kindness not to share your feelings, especially in the hectic weeks after a diagnosis.

MODERATOR: It's estimated that one in seven women will be diagnosed with breast cancer in their lifetimes. That's a lot of families who will share the burden of living through this disease. Yet your book is fairly unique. Why is that, do you think?

SILVER: Many publishers told me that men wouldn't buy a self-help book. So I think there's a certain resistance to such books in the business. But I used to say, if I had to fix my toilet, I'd sure buy a self-help book. Facing breast cancer was just such a challenge that I would have welcomed any help out there.

I think this is really a book for couples, not just for husbands. I interviewed more than 100 breast cancer survivors and their spouses, and in some ways I think the book is like a support group when you read it. You hear how others have coped, or in some cases like me, not coped so well, and that knowledge can be very helpful.

MODERATOR: You mentioned speaking with other couples that were going through what you and your wife did. Did you come away with any "dos and don'ts" for men when it comes to being supportive?

SILVER: Funny you should ask. The one thing I learned is every couple copes differently, and it's too simplistic to give a list of 10 things to do or not to do, and yet I came to see there are certain rules that would hold true.

The No. 1 rule for the breast cancer husband is to shut up and listen.

No. 2: It's not about you; it's about your wife. So if the doctor's making eye contact with you and not her, that's not the way it should be.

No. 3: Your wife is the boss. She may ask you what you think and you can certainly tell her, but in the end, she must make the decisions that make sense to her and her medical team.

No. 4: Sex doesn't have to take a holiday. Many men are afraid to approach their wives sexually during treatment. But the loss of intimacy is a huge loss. You have to respect your wife's mood, of course, maybe she just wants a good cuddle or back rub, but don't pull away.

No. 5: Take care of yourself, too. Caregivers need to have down time and strength to carry on. Just ask your wife for permission before you go out for a golf game.

MEMBER QUESTION: How do I get my husband to open up and talk about what I'm going through? He says he will support me through everything, but I need him to listen and be there for me. Any suggestions?

SILVER: A social worker told me about a technique called paired sharing. Guys, don't be frightened. You and your wife should find a quiet half hour in the week sit down with some tea, wine, or coffee, and talk.

She tells you what she's feeling, and your job is to repeat back to her what she said, which is harder than it sounds. With this technique, your job isn't to respond to her emotions, but to really hear them. And when she's finished, you get a turn, too.

MEMBER QUESTION: How do you handle telling other family members?

SILVER: We told the kids four days after that Friday phone call. We didn't want to worry them the weekend before school started. But keeping that secret was almost impossible. The advice I heard from experts is that both parents should tell the kids as soon as they're able, because the kids will surely know that something's not right if you don't tell them.

We told our kids that Marsha was going to have surgery, chemotherapy, and radiation treatments, which would be very hard to cope with, but her prognosis was good, which it was. And because our kids were typical teenagers, they believed us, and they carried on as teenagers do during the months ahead. They were very helpful sometimes, and I had to learn that they couldn't read my mind if I needed them to help; I had to ask.

MEMBER QUESTION: I've always been the main caretaker in our family, even of my husband's parents. But now my husband has to do some taking care of me, and neither one of us is comfortable with this role change. How did you and your wife adjust to this?

SILVER: It wasn't that hard for me, because I like to cook (but not to clean). But I know for many couples this is very difficult. One man told me how his wife came home from chemotherapy that first day and went upstairs to bed. He was in the den watching TV. Then he heard the toilet flush and he heard the phone ring, so he knew she'd been sick, called the doctor, and didn't want to bother him. So he said to her, "What do you think I am, a potted plant?" That helped his wife learn to accept his caregiving.

"Even if breast cancer does seem like an alien world, I think the women in that world really appreciate it when the men they love step up."

MEMBER QUESTION: As a man, I feel a bit like an alien in the breast cancer support community. Not to be sexist or anything, but it's really a girls' club. Did you ever feel that way?

SILVER: I walked in the Avon Breast Cancer Walk last year and there were 900 women and 40 guys. So we men were outnumbered. I know what you mean; I'm not a big fan of the color pink, but what I found at the Avon Walk was that the women there were thrilled to see guys who cared enough to be part of the event. So even if breast cancer does seem like an alien world, I think the women in that world really appreciate it when the men they love step up.

MEMBER QUESTION: Are there breast cancer husband organizations out there where we men can share our experiences and advice with other guys who are dealing with their wives' cancer?

SILVER: Yes, there are a few resources:

The Why Me Breast Cancer hotline has husbands on call at their toll-free number. The phone number is 800-221-2141.

The web site breastcancer.org also has a message board for family members of breast cancer patients, and men sometimes post there.

In some communities there are support groups for couples and occasionally for husbands only. You might check with a local breast cancer center.

There's also a group called Men Against Breast Cancer, run by Marc Heyison. They have a web site that describes their educational programs and online resources.

MEMBER QUESTION: What things can a husband do that are most helpful?

SILVER: I gave some suggestions earlier in the chat, but let me add a few more:

Flowers work wonders. I didn't quite understand why a beautiful bouquet would cheer my wife up in the midst of her breast cancer battle. But it did. A month later someone said to me, "Flowers; how romantic." And then I got it. Material gifts are only things, but they can make your wife feel better, too. Some people call it the tumor upgrade.

I think laughing with your wife is also one of the best ways to fight back at cancer. There's even a study that shows how humor can reduce the woman's distress, but you do have to watch the nature of the dose. One husband teased his wife after her mastectomy by saying, "The other was always my favorite, anyway," and she loved it. She told me, "It's the greatest thing in the world to be able to laugh."

MEMBER QUESTION: Did you feel neglected at all by family and friends, like all of the focus was on your wife and you needed some help/attention too?

SILVER: I did, and I felt guilty for having those feelings. But they're very natural. The husband of a cousin who had breast cancer warned me, "Everyone will be asking you how Marsha is, and that's as it should be. But anytime you want to talk about how you are, give me a call." And that was great. Some men told me their male buddies pulled away after a diagnosis. Maybe they were afraid they didn't know what to say. But other guys told me they'd go out for a night with the boys and that was a great chance to talk about how they were doing, too.

MEMBER QUESTION: Did you help her gather information about breast cancer? There seems to be so much you have to learn right away when you get a breast cancer diagnosis.

SILVER: My wife got the Susan Love book, which is a phenomenal resource, so she would read the book and underline passages for me to look at. My job was to do the online researching, so Marsha would tell me, "I heard about a treatment that keeps your hair from falling out during chemotherapy, can you check it out?" I did find the treatment, but unfortunately, it didn't work.

In the book I talk about the questions you should ask the doctor. Every patient will have a different set of circumstances to cope with, but there are certain things you should listen for when you and your wife visit the doctor. For example, one woman told me her doctor said that after a surgical biopsy, cancer cells spread rapidly and you have to make up your mind about surgery right away. A breast surgeon told me that's nonsense. In most cases you have a couple of weeks after diagnosis to make up your mind.

And if a doctor says, "If this were my wife, this is what I would recommend," that may sound reassuring, but it's really not very helpful. The doctor doesn't know your wife, and can't imagine how she will make her decision. So part of the husband's job in the doctor's office is to listen carefully to what the doctor is saying and making sure his advice is right for your wife.

MEMBER QUESTION: How did you balance the demands of your job with the new demands of helping your wife get well?

SILVER: I was very lucky. My boss said, "Take as much time as you need," and I know not every boss is that understanding. But I still felt absolutely overwhelmed. It was as if I was carrying a plate on one hand and people kept dumping more stuff on it. I really was afraid sometime I would just lose it. But as the weeks went on, and Marsha made decisions about her treatment, we both felt a little less anxious. And truthfully, I looked forward to coming into work, because it was one place where I knew what I was doing, unlike the breast cancer world.

"Part of the husband's job in the doctor's office is to listen carefully to what the doctor is saying and making sure his advice is right for your wife."

MODERATOR: For a lot of men, the one person they can talk to about their stress or fear or unhappiness is their wife, but the source of these feelings was your wife's illness. Did you still talk to her about those feelings?

SILVER: A lot of men have told me that they felt they lost their confidante because they felt they couldn't burden their wife with all their feelings. That's why a support group for guys only or a hotline call can be so helpful. One woman told me that breast cancer patients have to mother themselves as if they were their own sick child. So I think that many husbands do hold back some of their emotions out of respect. That's another reason why it's so important for the husband to take a break from caregiving every once in awhile.

MEMBER QUESTION: How did this whole experience change your relationship with your wife?

SILVER: Very interesting question. It did and it didn't change our relationship. We're now in what's called the "new normal" but in many ways it's a lot like the old normal, only with more stress. Breast cancer doesn't turn your marriage into a fairy tale relationship where you live happily ever after. Life goes on and you may still get on each other's nerves and squabble like any couple. But I think going through breast cancer has deepened our relationship. We know we're really there for each other, and that means a great deal. Plus, I still get Marsha flowers more than I used to.

MODERATOR: Do you find yourself worrying about the future -- whether the cancer may reoccur?

SILVER: I'd be lying if I said I didn't. But I'm pretty good at denial, as you can tell from my initial reaction. And I try to remember the advice my wife's oncologist gave her, "You can spend all your time worrying about a recurrence. If you never have a recurrence you've wasted all that time worrying, and if you do have a recurrence you've still wasted all that time worrying, when you could have been enjoying life."

MODERATOR: We are almost out of time. Before we wrap things up for today, do you have any final words for us, Marc?

SILVER: It's been so gratifying in the weeks since this book has been out, to hear from husbands and wives how much it has meant to them. And people also love the buttons I've been handing out when I speak. The button says, "Breast Cancer Husband, Shut Up and Listen."

MODERATOR: Our thanks to Marc Silver for joining us today. And thanks to you, members for your great questions. For more information please read his book, Breast Cancer Husband: How to Help Your Wife (and Yourself) Through Diagnosis, Treatment, and Beyond .